Artikel
Early and late mortality in vertebral osteomyelitis – who dies within the first year after diagnosis
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Veröffentlicht: | 25. Oktober 2022 |
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Gliederung
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Objective: Vertrebral osteomyelitis (VO) is a severe clinical entity associated with high mortality rates, especially within the first year after diagnosis. The aim of this study was to identify and compare predictive factors influencing early- and late- mortality in patients with conservative and surgically treated VO.
Methods: We conducted a prospective monocentric study including VO patients from 2008 to 2020 to determine early- (=death within 30 days after diagnosis) and late- (=death within day 31- day 365 after diagnosis) mortality rates. Additionally, multivariable analysis was performed to analyze predictive risk factors for mortality.
Results: In 323 evaluable patients early-mortality occurred in 17 (5%) and late-mortality in 61 (19%) patients. Multivariable analysis revealed chronic kidney disease (OR:9.073, 95%CI 4.186-19.666; p<0.001) and Staphylococcus aureus (OR:6.081, 95%CI 2.491-14.844; p< 0.001) were identified as independent risk factors for early-mortality whereas ASA score >2 (HR:5.237, 95%CI 2.588-10.597; p< 0.001), age >70 years (HR:2.417, 95%CI 1.575-3.708; p<0.001), chronic kidney disease (HR:1.950, 95%CI 1.254-3.032; p=0.003) and bacteremia (HR:1.829, 95%CI 1.238-2.701; p=0.002) were identified as independent risk factors for late-mortality.
Conclusion: Almost one out of four VO patients dies within the first year after diagnosis. Therefore, special attention should be paid to patients with associated risk factors, not only during hospitalization, but especially during the first year. Since renal failure in particular could be identified as a main risk factor, special caution is required when applying potentially nephrotoxic substances (e.g., analgesics or antibiotics) in order to avoid further renal damage.